Common issues in medical care for reproductive-age women include the diagnosis of pregnancy and the familiarity with normal and abnormal pregnancy findings. The question of whether the pregnant state is at risk for teratogenicity should be addressed. Ultrasonography can also be used to diagnose early pregnancy. Although history and physical examination are not sensitive tools for early diagnosis, knowing the characteristics of a normal pregnancy can alert the clinician to abnormalities such as coexisting disorders or ectopic pregnancy may help.
Any pregnant woman in her first trimester with lower abdominal pain, bleeding or history of an ectopic or impending miscarriage should be evaluated and excluded.
This section will discuss the signs and symptoms and diagnoses of early pregnancy. Ectopic and miscarriage are both non-viable pregnancies. They are discussed separately (see “Pregnancy Loss (miscarriage),: Terminology and risk factors and aetiology” or “Ectopic Pregnancy: Clinical manifestations, diagnosis”). Topic reviews that discuss specific medications during pregnancy are available as well as Lexicomp drug interaction monographs.
PHYSIOLOGY OF NORMAL PREGNANCY
End-organ effects of hormonal and mechanical changes can account for most of the clinical findings that are associated with normal pregnancy. These pathophysiologic changes will be described separately.
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Literature review up to Jan 2022. This topic last updated: February 18, 2022.
- Fisher TD. The effects of social norms and the sex of the experimenter on sexual behavior reports in young women and men. Arch Sex Behav 2007; 36:89.
- Ananth CV, Savitz DA. A meta-analysis of vaginal bleeding and adverse reproductive outcomes. Paediatr Perinat Epidemiol 1994; 8:62.
- Harville EW. Wilcox AJ. Baird DD. Weinberg CR. Early pregnancy can cause vaginal bleeding. Hum Reprod 2003; 18:1944.
- Sayle AE. Wilcox A.J., Weinberg C.R., Baird D. Prospective study on the onset and progression of symptoms in pregnancy. J Clin Epidemiol 2002; 55:676.
- Leiva MC, Tolosa JE, Binotto CN, et al. The first trimester of fetal cardiac development and hemodynamics. Ultrasound Obstet Gynecol 1999; 14:169.
- Wilcox AJ. Baird DD. Weinberg CR. Time from conception to the loss of pregnancy. N Engl J Med 1999, 340:1796.